Provides Case management to residents as directed by plan of care and physicians orders.
QUALIFICATIONS AND JOB SKILLS
The case manager position, using discretion and independent judgment, is responsible for coordinating the delivery of quality patient care by assuring that the nursing care plan is followed. This position requires skill in planning and organizing care. This position applies advanced nursing clinical skills in maintaining records and charts, in preparing written reports, in teaching other nursing-related skills, and in maintaining effective working relationships with others. This position combines the activities of direct and indirect care to geriatric patients. Requires up-to-date Registered Nurses License issued by the State of South Dakota.
Must have ability to interact well with residents and families, physicians, and staff; work as part of a team. Must have good basic interpersonal skills –oral and written communication skills, positive, patient attitude and willingness to work as a member of a team to accomplish assigned tasks. Must demonstrate ability to be energetic, enthusiastic and creative in working with residents. Must have ability to understand and follow task orientation and instructions, rules and procedures as outlined in orientation and training. Must be able to push and pull 60 pounds, must be able to lift 50 pounds and must be able to carry 15 pounds with two hands
ESSENTIAL DUTIES AND RESPONSIBILITIES
Model the values, mission, and vision of the organization;
Be alert and active in supporting facility’s commitment to safe practices, infection control, and respect for residents’ rights;
- Participates in the assessment, evaluation and planning of patient care, and revising as necessary, to include completion of all required documentation. Ensures these documents are accurate and submitted timely as per policy and procedures.
- Administers nursing care as ordered by the care plan and physician orders.
- Uses proper techniques in performing direct patient care. This requires substantial and specialized nursing skills that are consistent with scientific principles, agency policy and procedures, accepted standards of care, and review-body regulations and requirements.
- Identifies and communicates significant abnormalities in the patient data to appropriate team members who are responsible for coordination of all patient services.
- Utilizes the appropriate charting format and documents accurately and timely with an understanding of the legal implications.
- Documents on patient charts to correlate with the nursing care plan and physician’s orders.
- Maintains a safe patient environment.
- Monitors correctness and timely completion of lab work. Reports abnormal values to the physician, and documents all follow-up.
- Ensures that changes of orders are completed as needed.
- Completes monthly schedule as per protocol and submits it before actual implementation.
- Ensures that all disciplines are scheduled based on plan of care and order frequencies and that visits are made timely.
- Serves as patient advocate, assessing care and ensuring that quality care is given.
- Communicates the patient plan of care with the physician, patient and care team members. Remains aware of patient needs and changes in patient’s condition.
- Reviews all daily logs and visit notes of staff to ensure appropriate intervention based on plan of care; monitors accuracy of documentation.
- Ensures that records/documentation and daily logs are submitted to accounts payable in a timely manner and as per agency policy and procedures.
- Responsible for (i) assuring the development of an exceptional resident service plan which is the blue print of when, how, and who is to provide excellent resident care on a daily basis, (ii) making changes to the service plan when a resident’s condition changes and (iii) implementing this plan assuring the highest standards of care.
- Oversees work of subordinates (LPN, Resident Care Associates, C.N.A., Med Aid) and coordinates supervision with Director
- Performs direct patient care for all patients requiring skilled assessment and intervention.
- Ensures that equipment used by the team is well maintained, used appropriately, tracked and returned.
- Evaluates the effectiveness and outcome of care.
- Plans for the patient’s discharge.